Involuntary commitment bills aim to reform Virginia’s behavioral health processes

Members of the Joint Subcommittee to Study Mental Health Services in the Commonwealth in the 21st Century weighed in on bills concerning involuntary commitment into state hospitals on Monday. The committee discussed two bills, taking the thoughts of stakeholders and public comment into account.

 

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First up, members discussed HB 2329, which would require a secondary physician’s approval to release an involuntarily committed person from a state hospital before expiration of the 96-hour period following entry. The bill was introduced by Del. Kirk Cox in January after a patient was released early, despite still being in a state of distress, and attacked a family member, resulting in the family member’s death. 

Lisa Dailey, acting executive director for the Treatment Advocacy Center, referenced the complicated nature of involuntary patient releases in her testimony.

“The discharge [of the patient] can come down to who is on duty at the time.”

Sen. T. Monty Mason expressed some caution at the need for additional legislation, and asked if the hospital “missed steps” in the January case. For example, the patient had attacked another patient prior to their release from the hospital, but was not sent to court or other proceedings.

The committee’s general consensus on the bill called for a study of other states’ policies to find the best practices regarding involuntary patients’ release.

The second bill, also concerning involuntary commitment, was first introduced by Sen. R. Creigh Deeds in the 2020 session. SB 1049 would allow a person assisting someone in the involuntary commitment process to have access to medical records, notice of hearings, and participation in discharging the patient. 

The bill aims to allow more liberty for parents with adult children in the involuntary commitment process. However, stakeholders pushed back on allowing more access. Rhonda Thissen, senior advocate at the disAbility Law Center of Virginia, says guardians are not always the best source of care for patients.

“[More access] might be harmful for some families with a history of trauma and abuse.” 

Alternatively, committee members suggested promoting the use of advance directives, a  document that allows a person to give health care preferences including appointing a substitute decision maker for a time when they are unable to make those decisions.

Ultimately the committee decided to hold another hearing on the bill to hear more input from stakeholders before taking further action.